Riaz Nadeem, Sherman Eric, Koutcher Lawrence, Shapiro Lauren, Katabi Nora, Zhang Zhigang, Shi Weiji, Fury Mathew, Wong Richard, Wolden Suzanne, Rao Shyam, Lee Nancy
Departments of *Radiation Oncology †Medical Oncology ‡Pathology §Epidemology and Biostatistics ∥Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
Am J Clin Oncol. 2016 Feb;39(1):27-31. doi: 10.1097/COC.0000000000000006.
We previously reported inferior outcomes for locally advanced head and neck cancer treated with cetuximab (C225) versus cisplatin (CDDP). We now examine if this difference persists when accounting for HPV status and update outcomes on the entire cohort.
From 3/106 to 4/1/08, 174 locally advanced head and neck cancer patients received definitive treatment with RT and CDDP (n=125) or RT and C225 (n=49). Of these, 62 patients had tissue available for HPV analysis.
The median follow-up was 47 months. The 3-year loco-regional failure, disease-free survival, and overall survival for CDDP versus C225 were 5.7% versus 40.2% (P<0.0001), 85.1% versus 35.4% (P<0.0001), and 90.0% versus 56.6% (P<0.0001), respectively. In the subset with tissue, there was no difference in rates of HPV or p16 positivity between the 2 groups. In this subset, the 3-year loco-regional failure, disease-free survival, and overall survival for CDDP versus C225 were 5.3% versus 32.0% (P=0.01), 86.8% versus 43.2% (P=0.002), and 86.7% versus 76.9% (P=0.09), respectively. Multivariate analysis continued to show a benefit for CDDP.
With longer follow-up and the inclusion of HPV and p16 status for about one third of patients where tissue was available, we continued to find superior outcomes with concurrent CDDP versus C225.
我们之前报道了与顺铂（CDDP）相比，西妥昔单抗（C225）治疗局部晚期头颈癌的疗效较差。现在我们研究在考虑人乳头瘤病毒（HPV）状态时这种差异是否仍然存在，并更新整个队列的疗效。
从2006年3月至2008年4月1日，174例局部晚期头颈癌患者接受了放疗联合CDDP（n = 125）或放疗联合C225（n = 49）的根治性治疗。其中，62例患者有可用组织进行HPV分析。
中位随访时间为47个月。CDDP组与C225组的3年局部区域失败率、无病生存率和总生存率分别为5.7%对40.2%（P<0.0001）、85.1%对35.4%（P<0.0001）和90.0%对56.6%（P<0.0001）。在有组织的亚组中，两组之间HPV或p16阳性率没有差异。在该亚组中，CDDP组与C225组的3年局部区域失败率、无病生存率和总生存率分别为5.3%对32.0%（P = 0.01）、86.8%对43.2%（P = 0.002）和86.7%对76.9%（P = 0.09）。多因素分析继续显示CDDP有益。
随着更长时间的随访以及纳入约三分之一有可用组织患者的HPV和p16状态，我们继续发现同步使用CDDP比C225有更好的疗效。
